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PSY1204 > Introduction to Personality Disorders > Flashcards

Introduction to Personality Disorders Flashcards

1
Q

Definition of personality disorder?

A
  • abnormality of social relationships and functioning
  • is persistent
  • inflexible and enduring pattern of perceiving, relating to and thinking about the outside world/self
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2
Q

What are personality disorders characterised by?

A
  • disruptions in the mind

- subjectivity, consciousness, intentionality and the unconscious, agency

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3
Q

What are the categorical approaches of diagnostic systems?

A
  • A (paranoid, schizoid, schizotypal)
  • B (antisocial, borderline, narcissistic)
  • C (avoidant, dependent, obsessive-compulsive)
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4
Q

What is the morbidity (illness/suffering) of personality disorders?

A
  • social functioning (impaired social adjustment, issues in relationships)
  • mental disorder (instability of mood, depression, anxiety, panic attacks etc)
  • criminality (associated with violent behaviour)
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5
Q

What are some of the co-morbid health problems that accompany personality disorders?

A
  • depression
  • bipolar disorder
  • anxiety
  • substance misuse
  • ADHD
  • eating disorders
  • somatisation
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6
Q

Definition of complex trauma?

A

-repeated traumatic events that occurred during a persons early psychological development

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7
Q

Characteristics of complex trauma?

A
  • dissociation
  • somatisation
  • re-victimization
  • affect dysregulation
  • disruptions in identity
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8
Q

Definition of simple trauma?

A
  • single traumatic incident that threatened potential future existence
  • likely not a background in mental health problems
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9
Q

Felitti et al (2002)

adverse childhood experiences

A
  • 17,000 US people completed retrospective survey, diagnosed with emotionally unstable personality disorder
  • 2 out of 3 had at least one adverse experience
  • 1 in 6 reported 4 or more ACEs
  • experiences included physical abuse, separation, emotional neglect, household mental illness etc
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10
Q

What is complex PTSD characterised by?

A
  • re-experiencing in the present
  • avoidance
  • excessive current threat
  • disturbances in self organization
  • affect dysregulation
  • negative self-concept
  • disturbances in relationships
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11
Q

What are the psychosocial factors of BPD (borderline personality disorder)?

A
  • parental separation or loss
  • family history of mood disorder/ substance misuse
  • abnormal parenting attitudes (low care with high overprotection)
  • childhood trauma
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12
Q

What are the genetic causes of personality disorders?

A
  • little evidence of a link to schizophrenia or mood disorder
  • BPD had concordance rate of 35% in MZ twins, but 7% for DZ twins
  • aggressive antisocial behaviour is more heritable than non-aggressive
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13
Q

What are the neurotransmitter causes of personality disorders?

A
  • impulsiveness, auto-aggression and outwardly directed aggression are linked to serotonergic dysfunction
  • enhanced dopaminergic activity in psychotic-like thinking
  • noradrenergic abnormalities associated with risk taking and sensation seeking
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14
Q

What are the developmental theories of personality disorders?

A
  • Bowlby (1969) attachment theory refers to how mothers and babies form attachments in early months of life
  • may have insecure attachments, those with personality disorders have greater incidence of anxious/ambivalent/avoidant attachment
  • Kernberg (1975) found excessive aggression leads to splitting
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15
Q

How is medication used as treatment for personality disorder?

A
  • current randomized trial of clozapine
  • limited evidence for mood stabilisers
  • treats symptoms but not root
  • has issues (overmedication, misdiagnosis etc)
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16
Q

What are the psychological therapies for BPD?

A
  • dialectical behaviour therapy (DBT) (strongest evidence)
  • mentalisation-based therapy (MBT) (strongest evidence)
  • transference focused therapy
  • therapeutic community
  • schema focussed CBT
17
Q

What is the biosocial theory for BPD?

A
  • interaction between emotional vulnerability and pervasive invalidation
  • pov of child is negated by caregiver so develop maladaptive ways of coping leading to behaviour problems (emotional dysregulation)
  • cycle of emotional vulnerability, pervasive invalidation and emotional dysregulation
18
Q

What is the emotional vulnerability of people with BPD?

A
  • high sensitivity (immediate reactions, low threshold for emotional reactions)
  • high reactivity (high arousal, extreme reactions)
  • slow return to baseline (long-lasting reactions, contributes to high sensitivity for next stimulus)
19
Q

What did the randomized clinical trials of DBT find?

A
  • found it was superior to controls in 4 independent research labs
  • reduced suicide attempts, medical risk, drug abuse, depression, anger, ER admissions
  • increased global and social adjustment
20
Q

How is reflective function and attachment linked to personality disorders?

A

-Fonagy (1994) found strong relationship between RF and scores in strange situation tests

21
Q

What’s the neurological basis of mentalisation?

A
  • right hemisphere is specialised for emotion and social cognition
  • optimal development associated with development of affect regulation associated with the VMPF cortex
  • arousal and mentalisation
22
Q

What are the failures of mentalisation?

A
  • psychic equivalence
  • teleological stance
  • hyperactive mentalisation and pretend mode (overthinking without feeling)
23
Q

What’s involved in transference focussed therapy?

A
  • object dyads in which positive and negative object representations are kept apart
  • focuses on understanding the positive and negative attributions to relationships and helping them tolerate the positive and negative attributes in other people
24
Q

What’s involved in therapeutic community?

A
  • group of patients will be invited to participate with onsite staff
  • has important and central role in helping people to understand and tolerate their relationships with others

PSY1204 (14 decks)

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